title: Use of the elderly risk assessment (ERA) index to predict 2-year mortality and nursing home placement among community dwelling older adults.
abstract: The objective was to determine the relationship between a high score on the ERA index and 2-year mortality and nursing home placement. As of January 1, 2005, 12,650 community-dwelling patients over 60 years of age were impaneled with a primary care practice at the Mayo Clinic in Rochester, MN. This was a retrospective cohort study utilizing an administrative risk score, the ERA score. Primary outcomes were 2-year mortality and 2-year nursing home placement. The predictor variable was ERA score. Relative risk estimates were used to describe the association between the ERA index and mortality and nursing home placement. The relative risk of 2-year mortality was 51.4 (95% confidence interval=CI=28.0-94.4) in patients in the highest risk group compared to the lowest group. The relative risk of nursing home placement was 113.2 (95% CI=76.1-168.4). Patients with high ERA scores are at high risk for 2-year mortality and 2-year nursing home placement. These findings suggest that the utilization of an electronic risk score can help identify patients at risk for death or nursing home placement. Clinically, the identification of high risk individuals may be useful for utilization of clinical case management.
authors.affiliation: Division of Primary Care Medicine, Department of Internal Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA. takahashi.paul@mayo.edu
authors.forename: Paul Y
authors.initials: PY
authors.lastname: Takahashi
authors.forename: Ericka E
authors.initials: EE
authors.lastname: Tung
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Crane
authors.forename: Rajeev
authors.initials: R
authors.lastname: Chaudhry
authors.forename: Stephen
authors.initials: S
authors.lastname: Cha
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Hanson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D009026:Mortality; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012189:Retrospective Studies; D018570:Risk Assessment